Olmesartan Medoxomil - Indications and Contraindications.
What is a Olmesartan Medoxomil?
Olmesartan Medoxomil is a indicated for in the treatment of the high blood pressure or a hypertension. It was a developed by the Japanese pharmaceutical in a company Sank-yo in a 1995. Olmesartan is a administered as an a ester pro-drug called a Olmesartan medoxomil and is a completely and rapidly hydrolyzed to the active acid form.
Olmesartan Medoxomil can be used alone or in a combination with other anti-hypertensive drugs in a adults and children who are 6 years or a older.
High blood pressure that is not a treated over to a period of the time can be cause damage to the arteries of the heart, brain, eyes and kidneys. Complications that could arise by not controlling to your blood pressure are heart disease like a heart attacks and heart failure, stroke, kidney failure and loss of the vision.
Lifestyle changes are as a important as taking a medications in the case of the high blood pressure. Maintaining to a low-fat and low-salt diet and a healthy weight, exercising 30 minutes for a most days, not a smoking and using alcohol in a moderation are some of the changes that have to be a incorporated into the daily routine.
What is a Blood Pressure?
Blood pressure is the product of the cardiac output (CO) and the peripheral resistance (P V).
Cardiac output is the amount of the blood pumped by in the heart per minute and is the product of the heart rate ( in the beats per minute) and in the stroke volume (amount of the blood pumped per beat). Peripheral resistance is the resistance to the blood flow in the arteries.
An a increase in a cardiac output or a peripheral resistance can be a increase blood pressure. Cardiac output increases when there is a excess sodium re-absorption by in the kidneys that causes water retention in the body. Peripheral resistance increases when the arteries constrict there by increasing in the resistance to the blood flow.
What is the Mechanism of the Action of the Olmesartan Medoxomil?
Olmesartan Medoxomil belongs to the class of the drugs known as a angiotensin 2 receptor blockers or a A R B s that block in the binding of the angiotensin 2 to it is a receptor.
Angiotensin 2 is a part of the rennin-angioplasty-aldosterone in a system (R A S), an a important pathway through which many of the anti-hypertensive drugs work.
Angiotensin 2 causes
Tightening of the blood vessels (systemic vasoconstriction in the arteries).
Increase in a sodium re-absorption and as a result increased water retention in the kidney tubules. This results in a increase in a blood volume, forcing in the heart to the pump out more blood while a contracting. This increases cardiac output.
Release of a steroid hormone aldosterone that also a acts to the increase sodium and water retention.
Vasoconstriction and sodium re-absorption cause an a increase in a blood pressure.
When a A R B s like a Olmesartan Medoxomil block angiotensin 2 from a binding to it is a receptor:
The blood vessels stay a open (vasodilation).
There is reduction in the secretion of the aldosterone.
These effects are reduce blood pressure. Blood flows more smoothly through in the blood vessels and the heart is a able to the pump more efficiently.
What are the Uses of the Olmesartan Medoxomil?
Olmesartan Medoxomil is a indicated in the following condition:
Hypertension (either alone or in a combination with a diuretics).
It is also a sometimes used in the following conditions:
Heart failure (when in the heart is a unable to the pump enough blood to the rest of the body).
Diabetic nephropathy (a chronic kidney disease in a people with a diabetes).
A R B s in a general are also known to improve in the chances of the survival after a heart attack.
What are the Side Effects of the Olmesartan Medoxomil?
Olmesartan Medoxomil could cause in the following side effects:
Headache
Back pain
Diarrhea - Chronic diarrhea with a substantial weight loss may be require a discontinuation of the treatment
Dizziness
Allergic reaction that may be a cause troubled breathing or a swallowing, and swelling in a any part of the face
Upper respiratory tract infection with a symptoms like a hoarse voice and cough
Increase in a blood potassium levels
Low blood pressure in those with a low blood volume or a low sodium levels
What are the Contraindications of the Olmesartan Medoxomil?
Olmesartan Medoxomil is a contraindicated in:
Pregnant women, especially in the second and third trimesters as it can be cause reduced fetal renal function and increase in the risk of the fetal injury and death. It can also a cause fetal malformations are including skeletal deformities.
Children under a 1 year old as it can affect in the development of their kidneys.
Patients with a diabetes who are also a taking another drug called a aliskiren
Patients with a stenosis of the renal arteries (narrowed arteries supplying in the kidney).
What are the Doses and Combinations of the Olmesartan Medoxomil given for a Hypertension?
1. Olmesartan Medoxomil alone:
Adults: A starting dose of the 20 milligrams (mg) per day as a tablet is a prescribed to be a taken orally which can be a increased after a 2 weeks to 40 mg per day. It can be a taken with a food or on an a empty stomach. There is no advantage of the consuming more than 40 mg a day or a splitting in the dose into 2 per day.
Like other anti-hypertensive medications, Olmesartan Medoxomil only keeps in the blood pressure under control and does not cure it. The blood pressure may be decrease in the first week of the treatment but you are require up to the 2 weeks to experience in the full benefit of the drug.
Children (6 to 16 years): The dose is a based on body weight and can be a given a tablet or oral suspension. Usually between 20 to 40 mg per day (for a children weighing above 35 kilograms) and between 10 to 20 mg per day (for a children above 20 kg and less than 35 kg) is a given.
It is not a effective in a children less than 6 years and should not be a given to the infants less than 1 year.
2. Combination therapy:
Olmesartan Medoxomil can be also be taken in a combination with other anti-hypertensive agents.
3.With a hydrochloride:
Hydrochloride acts as a diuretic increasing in the flow of the urine out of the body thereby reducing in the amount of the water in the body. This lowers in the blood pressure.
Adults: One tablet a day
Children: As a prescribed by the doctor.
4. With a hydrochloride and amlodipine:
Amlodipine is a calcium channel blocker in that acts by a blocking in the flow of the calcium into the cells of the heart and blood vessels. Effects are relaxing in the blood vessels thus lowering blood pressure.
Adults: One tablet a day ( in the maximum dose per day for a Olmesartan Medoxomil should be a 40 mg, for a hydrochloride should be 25 mg and for a amlodipine should be 10 mg).
Children: As a prescribed by a doctor.
What are the Drug Interactions of the Olmesartan Medoxomil?
Most drugs consumed are changed into a more soluble forms before they are excreted from the body. The predominant enzymes in the conversion of the drugs belong to a complex called the cytochrome P 450 (C Y P) complex that is a mostly present in the liver but can be a present in other organs too.
Olmesartan Medoxomil is not a metabolized by the cytochrome P 450 pathway. It is not expected to have a any interactions with a drugs in that increase, decrease or are metabolized by in the C Y P in a enzymes.
Olmesartan Medoxomil is a excreted as the unchanged drug.
Olmesartan Medoxomil should not be a administered with a aliskiren in a patients with a diabetes. Aliskiren is a rein inhibitor used to the treat hypertension. Since aliskiren also a works through R A S in the dual blockade of the system could cause altered sodium and potassium levels and renal impairment.
Olmesartan Medoxomil should not be a consumed with a certain other drugs and in a certain conditions. The dosage or the interval of the dosing can be a changed after consulting with your doctor.
Colesevelam hydrochloride is a bile acid sequestering agent. When taken a together, colesevelam reduces in the availability of the Olmesartan Medoxomil. Hence stagger in the timings.
Angioplasty are converting in a enzyme (ACE) inhibitors are used to the treat hypertension (Benzedrine, captivator, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril or trandolapril). These also work through the RAS system. This dual blockade of the system could cause low blood pressure, increase in a potassium levels and kidney impairment.
Lithium is used to the treat bipolar disorder. When take a together lithium toxicity could occur; hence monitoring lithium levels is a important.
When Non-steroidal anti-inflammatory agents or a NSA-IDs are used by the elderly or a those who have a compromised renal function, co-administration with a Olmesartan Medoxomil may be cause renal impairment; monitor in the renal function regularly in a patients who take a Olmesartan Medoxomil with any of the NSA-IDs.
Olmesartan Medoxomil is not a affected by a food and can be taken along with a digoxin, warfarin and antacids.
References:
Brenner HR. Olmesartan Medoxomil medoxomil: current status of its use in a mono-therapy. Vascular Health and Risk Management. 2006;2(4):327-340.
Andrew Whit-taker. A Review of the Olmesartan Medoxomil Medoxomil -- A New Angioplasty II Receptor Blocker. Br J Cardio l. 2005;12(2):125-12.
Olmesartan -
(https://en.wikipedia.org/wiki/Olmesartan Medoxomil)
Label: OLMESARTAN MEDOXOMIL- olmesartan medoxomil tablet, film coated -
(https://medlineplus.gov/druginfo/meds/a603006.html)
About Olmesartan -
(https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58a1371d-bf52-4dcf-a504-4c9eee565c02)
